Amended IN Senate June 29, 2017 Amended IN Assembly April 20, 2017 Amended IN Assembly April 06, 2017 CALIFORNIA LEGISLATURE 20172018 REGULAR SESSION Assembly Bill No. 44Introduced by Assembly Member Reyes(Coauthors: Assembly Members Aguiar-Curry, Chu, Cooley, Gipson, Holden, Kalra, Limn, Medina, Rodriguez, Rubio, Mark Stone, and Voepel)(Coauthor: Senator Leyva)December 05, 2016 An act to amend Section 4656 of, and to add Section 4600.05 to to, the Labor Code, relating to workers compensation. LEGISLATIVE COUNSEL'S DIGESTAB 44, as amended, Reyes. Workers compensation: medical treatment: terrorist attacks: workplace violence.Existing law establishes a workers compensation system, administered by the Administrative Director of the Division of Workers Compensation, to compensate an employee for injuries sustained in the course of his or her employment. Under existing law, an employer must provide reasonably required treatments, including, but not limited to, medical and surgical treatment, to cure or relieve an employees injuries sustained in the course of his or her employment. Existing law requires an employer to establish a utilization review process to review, approve, modify, or deny a treatment claim.This bill would require employers to provide immediately accessible advocacy services to employees employees, including first responders, injured in the course of employment by an act of domestic terrorism, as defined, when the Governor has declared a state of emergency due to that act of domestic terrorism. and would require employer-appointed advocates to assist employees and others to obtain approval for medical treatments, as specified. The bill would establish a disputable presumption that physician-requested treatment is appropriate, set parameters for approving or denying treatment, and create processes for when treatment is denied. The bill would apply retroactively to employees and first responders injured in an act of domestic terrorism before January 1, 2018.Existing workers compensation law prohibits aggregate disability payments for a single injury occurring on or after April 19, 2004, causing temporary disability from extending for more than 104 compensable weeks, as specified. Existing law lists exempted injuries and conditions for which aggregate disability payments may be made for not more than 240 compensable weeks within a 5-year period.This bill would add injuries arising from an act of domestic terrorism to the list of injuries and conditions for which aggregate disability payments may be made for not more than 240 compensable weeks within a 5-year period.Digest Key Vote: MAJORITY Appropriation: NO Fiscal Committee: YES Local Program: NO Bill TextThe people of the State of California do enact as follows:SECTION 1. Section 4600.05 is added to the Labor Code, to read:4600.05. (a) All employers, as defined in Section 3300, shall provide immediately accessible advocacy services for employees employees, including first responders, injured in the course of employment by an act of domestic terrorism, as defined in Section 2331 of Title 18 of the United States Code, to assist injured employees in obtaining medical treatment and to assist providers of medical services in seeking authorization and payment of medical treatment. These advocacy services may be provided by the employer, the employers insurer, or the employers claims administrator.(b)This section shall apply only when the Governor has declared a state of emergency pursuant to subdivision (b) of Section 8558 of the Government Code in connection with the act of domestic terrorism.(b) Medical treatment, including psychological counseling, requested by a physician treating an employee pursuant to subdivision (a) shall be presumed to be consistent with the guidelines adopted by the administrative director pursuant to Section 5307.27. This presumption is disputable and may be controverted by other evidence, but unless so controverted, the independent medical reviewer and the appeals board are bound to find in accordance with it. The absence of documentation is not sufficient to rebut this presumption if the documentation is in the possession of, or available to, the employer, the employers insurer, or the employers claims administrator.(c) The determination to authorize or deny requested medical treatment shall be made in a timely fashion that is appropriate for the nature of the employees condition, not to exceed five working days from the receipt of the request for authorization. If the treatment is denied, an independent medical review determination shall be issued no more than 45 days from the receipt of the request for authorization.(d) The advocate provided by the employer pursuant to subdivision (a) shall assist the employee, the employees physician, and the employees representative, if any, to obtain authorization for the requested medical treatment, shall ensure the independent medical review process described in subdivision (c) is initiated in a timely manner, and shall provide the independent medical reviewer a narrative explaining why the treatment should be authorized, including citing relevant medical records.(e) If the treatment is denied, or if the employer, insurer, or advocate provided by the employer pursuant to subdivision (a) fails to meet the timeframes or any other requirements of this section, the appeals board shall determine whether the requested treatment and all subsequently requested treatment and all subsequently requested treatment is medically necessary. An expedited hearing shall be held and the determination shall be made and filed within 30 days after the declaration of readiness is filed.(c)Nothing in this section is(f) This section is not intended to alter the conditions for compensability of an injury, as defined in Section 3600.(g) The time limits in this section are mandatory. To the extent that the provisions of this section conflict with the provisions of Sections 4610 and 4610.5, the provisions in this section shall control.(d)(h) The administrative director shall adopt regulations to implement this section. section no later than July 1, 2018.(i) This section, and subparagraph (J) of paragraph (3) of subdivision (c) of Section 4656 shall apply retroactively to the employees and first responders injured in the terrorist attack in San Bernardino on December 2, 2015, and any other employees or first responders injured by an act of domestic terrorism that occurred before January 1, 2018.SEC. 2. Section 4656 of the Labor Code is amended to read:4656. (a) Aggregate disability payments for a single injury occurring prior to January 1, 1979, causing temporary disability shall not extend for more than 240 compensable weeks within a period of five years from the date of the injury.(b) Aggregate disability payments for a single injury occurring on or after January 1, 1979, and prior to April 19, 2004, causing temporary partial disability shall not extend for more than 240 compensable weeks within a period of five years from the date of the injury.(c) (1) Aggregate disability payments for a single injury occurring on or after April 19, 2004, causing temporary disability shall not extend for more than 104 compensable weeks within a period of two years from the date of commencement of temporary disability payment.(2) Aggregate disability payments for a single injury occurring on or after January 1, 2008, causing temporary disability shall not extend for more than 104 compensable weeks within a period of five years from the date of injury.(3) Notwithstanding paragraphs (1) and (2), for an employee who suffers from the following injuries or conditions, aggregate disability payments for a single injury occurring on or after April 19, 2004, causing temporary disability shall not extend for more than 240 compensable weeks within a period of five years from the date of the injury:(A) Acute and chronic hepatitis B.(B) Acute and chronic hepatitis C.(C) Amputations.(D) Severe burns.(E) Human immunodeficiency virus (HIV).(F) High-velocity eye injuries.(G) Chemical burns to the eyes.(H) Pulmonary fibrosis.(I) Chronic lung disease.(J) Injuries arising from an act of domestic terrorism, as described in Section 4600.05.
Amended IN Senate June 29, 2017 Amended IN Assembly April 20, 2017 Amended IN Assembly April 06, 2017 CALIFORNIA LEGISLATURE 20172018 REGULAR SESSION Assembly Bill No. 44Introduced by Assembly Member Reyes(Coauthors: Assembly Members Aguiar-Curry, Chu, Cooley, Gipson, Holden, Kalra, Limn, Medina, Rodriguez, Rubio, Mark Stone, and Voepel)(Coauthor: Senator Leyva)December 05, 2016 An act to amend Section 4656 of, and to add Section 4600.05 to to, the Labor Code, relating to workers compensation. LEGISLATIVE COUNSEL'S DIGESTAB 44, as amended, Reyes. Workers compensation: medical treatment: terrorist attacks: workplace violence.Existing law establishes a workers compensation system, administered by the Administrative Director of the Division of Workers Compensation, to compensate an employee for injuries sustained in the course of his or her employment. Under existing law, an employer must provide reasonably required treatments, including, but not limited to, medical and surgical treatment, to cure or relieve an employees injuries sustained in the course of his or her employment. Existing law requires an employer to establish a utilization review process to review, approve, modify, or deny a treatment claim.This bill would require employers to provide immediately accessible advocacy services to employees employees, including first responders, injured in the course of employment by an act of domestic terrorism, as defined, when the Governor has declared a state of emergency due to that act of domestic terrorism. and would require employer-appointed advocates to assist employees and others to obtain approval for medical treatments, as specified. The bill would establish a disputable presumption that physician-requested treatment is appropriate, set parameters for approving or denying treatment, and create processes for when treatment is denied. The bill would apply retroactively to employees and first responders injured in an act of domestic terrorism before January 1, 2018.Existing workers compensation law prohibits aggregate disability payments for a single injury occurring on or after April 19, 2004, causing temporary disability from extending for more than 104 compensable weeks, as specified. Existing law lists exempted injuries and conditions for which aggregate disability payments may be made for not more than 240 compensable weeks within a 5-year period.This bill would add injuries arising from an act of domestic terrorism to the list of injuries and conditions for which aggregate disability payments may be made for not more than 240 compensable weeks within a 5-year period.Digest Key Vote: MAJORITY Appropriation: NO Fiscal Committee: YES Local Program: NO
Amended IN Senate June 29, 2017 Amended IN Assembly April 20, 2017 Amended IN Assembly April 06, 2017
Amended IN Senate June 29, 2017
Amended IN Assembly April 20, 2017
Amended IN Assembly April 06, 2017
CALIFORNIA LEGISLATURE 20172018 REGULAR SESSION
Assembly Bill No. 44
Introduced by Assembly Member Reyes(Coauthors: Assembly Members Aguiar-Curry, Chu, Cooley, Gipson, Holden, Kalra, Limn, Medina, Rodriguez, Rubio, Mark Stone, and Voepel)(Coauthor: Senator Leyva)December 05, 2016
Introduced by Assembly Member Reyes(Coauthors: Assembly Members Aguiar-Curry, Chu, Cooley, Gipson, Holden, Kalra, Limn, Medina, Rodriguez, Rubio, Mark Stone, and Voepel)(Coauthor: Senator Leyva)
December 05, 2016
An act to amend Section 4656 of, and to add Section 4600.05 to to, the Labor Code, relating to workers compensation.
LEGISLATIVE COUNSEL'S DIGEST
## LEGISLATIVE COUNSEL'S DIGEST
AB 44, as amended, Reyes. Workers compensation: medical treatment: terrorist attacks: workplace violence.
Existing law establishes a workers compensation system, administered by the Administrative Director of the Division of Workers Compensation, to compensate an employee for injuries sustained in the course of his or her employment. Under existing law, an employer must provide reasonably required treatments, including, but not limited to, medical and surgical treatment, to cure or relieve an employees injuries sustained in the course of his or her employment. Existing law requires an employer to establish a utilization review process to review, approve, modify, or deny a treatment claim.This bill would require employers to provide immediately accessible advocacy services to employees employees, including first responders, injured in the course of employment by an act of domestic terrorism, as defined, when the Governor has declared a state of emergency due to that act of domestic terrorism. and would require employer-appointed advocates to assist employees and others to obtain approval for medical treatments, as specified. The bill would establish a disputable presumption that physician-requested treatment is appropriate, set parameters for approving or denying treatment, and create processes for when treatment is denied. The bill would apply retroactively to employees and first responders injured in an act of domestic terrorism before January 1, 2018.Existing workers compensation law prohibits aggregate disability payments for a single injury occurring on or after April 19, 2004, causing temporary disability from extending for more than 104 compensable weeks, as specified. Existing law lists exempted injuries and conditions for which aggregate disability payments may be made for not more than 240 compensable weeks within a 5-year period.This bill would add injuries arising from an act of domestic terrorism to the list of injuries and conditions for which aggregate disability payments may be made for not more than 240 compensable weeks within a 5-year period.
Existing law establishes a workers compensation system, administered by the Administrative Director of the Division of Workers Compensation, to compensate an employee for injuries sustained in the course of his or her employment. Under existing law, an employer must provide reasonably required treatments, including, but not limited to, medical and surgical treatment, to cure or relieve an employees injuries sustained in the course of his or her employment. Existing law requires an employer to establish a utilization review process to review, approve, modify, or deny a treatment claim.
This bill would require employers to provide immediately accessible advocacy services to employees employees, including first responders, injured in the course of employment by an act of domestic terrorism, as defined, when the Governor has declared a state of emergency due to that act of domestic terrorism. and would require employer-appointed advocates to assist employees and others to obtain approval for medical treatments, as specified. The bill would establish a disputable presumption that physician-requested treatment is appropriate, set parameters for approving or denying treatment, and create processes for when treatment is denied. The bill would apply retroactively to employees and first responders injured in an act of domestic terrorism before January 1, 2018.
Existing workers compensation law prohibits aggregate disability payments for a single injury occurring on or after April 19, 2004, causing temporary disability from extending for more than 104 compensable weeks, as specified. Existing law lists exempted injuries and conditions for which aggregate disability payments may be made for not more than 240 compensable weeks within a 5-year period.
This bill would add injuries arising from an act of domestic terrorism to the list of injuries and conditions for which aggregate disability payments may be made for not more than 240 compensable weeks within a 5-year period.
## Digest Key
## Bill Text
The people of the State of California do enact as follows:SECTION 1. Section 4600.05 is added to the Labor Code, to read:4600.05. (a) All employers, as defined in Section 3300, shall provide immediately accessible advocacy services for employees employees, including first responders, injured in the course of employment by an act of domestic terrorism, as defined in Section 2331 of Title 18 of the United States Code, to assist injured employees in obtaining medical treatment and to assist providers of medical services in seeking authorization and payment of medical treatment. These advocacy services may be provided by the employer, the employers insurer, or the employers claims administrator.(b)This section shall apply only when the Governor has declared a state of emergency pursuant to subdivision (b) of Section 8558 of the Government Code in connection with the act of domestic terrorism.(b) Medical treatment, including psychological counseling, requested by a physician treating an employee pursuant to subdivision (a) shall be presumed to be consistent with the guidelines adopted by the administrative director pursuant to Section 5307.27. This presumption is disputable and may be controverted by other evidence, but unless so controverted, the independent medical reviewer and the appeals board are bound to find in accordance with it. The absence of documentation is not sufficient to rebut this presumption if the documentation is in the possession of, or available to, the employer, the employers insurer, or the employers claims administrator.(c) The determination to authorize or deny requested medical treatment shall be made in a timely fashion that is appropriate for the nature of the employees condition, not to exceed five working days from the receipt of the request for authorization. If the treatment is denied, an independent medical review determination shall be issued no more than 45 days from the receipt of the request for authorization.(d) The advocate provided by the employer pursuant to subdivision (a) shall assist the employee, the employees physician, and the employees representative, if any, to obtain authorization for the requested medical treatment, shall ensure the independent medical review process described in subdivision (c) is initiated in a timely manner, and shall provide the independent medical reviewer a narrative explaining why the treatment should be authorized, including citing relevant medical records.(e) If the treatment is denied, or if the employer, insurer, or advocate provided by the employer pursuant to subdivision (a) fails to meet the timeframes or any other requirements of this section, the appeals board shall determine whether the requested treatment and all subsequently requested treatment and all subsequently requested treatment is medically necessary. An expedited hearing shall be held and the determination shall be made and filed within 30 days after the declaration of readiness is filed.(c)Nothing in this section is(f) This section is not intended to alter the conditions for compensability of an injury, as defined in Section 3600.(g) The time limits in this section are mandatory. To the extent that the provisions of this section conflict with the provisions of Sections 4610 and 4610.5, the provisions in this section shall control.(d)(h) The administrative director shall adopt regulations to implement this section. section no later than July 1, 2018.(i) This section, and subparagraph (J) of paragraph (3) of subdivision (c) of Section 4656 shall apply retroactively to the employees and first responders injured in the terrorist attack in San Bernardino on December 2, 2015, and any other employees or first responders injured by an act of domestic terrorism that occurred before January 1, 2018.SEC. 2. Section 4656 of the Labor Code is amended to read:4656. (a) Aggregate disability payments for a single injury occurring prior to January 1, 1979, causing temporary disability shall not extend for more than 240 compensable weeks within a period of five years from the date of the injury.(b) Aggregate disability payments for a single injury occurring on or after January 1, 1979, and prior to April 19, 2004, causing temporary partial disability shall not extend for more than 240 compensable weeks within a period of five years from the date of the injury.(c) (1) Aggregate disability payments for a single injury occurring on or after April 19, 2004, causing temporary disability shall not extend for more than 104 compensable weeks within a period of two years from the date of commencement of temporary disability payment.(2) Aggregate disability payments for a single injury occurring on or after January 1, 2008, causing temporary disability shall not extend for more than 104 compensable weeks within a period of five years from the date of injury.(3) Notwithstanding paragraphs (1) and (2), for an employee who suffers from the following injuries or conditions, aggregate disability payments for a single injury occurring on or after April 19, 2004, causing temporary disability shall not extend for more than 240 compensable weeks within a period of five years from the date of the injury:(A) Acute and chronic hepatitis B.(B) Acute and chronic hepatitis C.(C) Amputations.(D) Severe burns.(E) Human immunodeficiency virus (HIV).(F) High-velocity eye injuries.(G) Chemical burns to the eyes.(H) Pulmonary fibrosis.(I) Chronic lung disease.(J) Injuries arising from an act of domestic terrorism, as described in Section 4600.05.
The people of the State of California do enact as follows:
## The people of the State of California do enact as follows:
SECTION 1. Section 4600.05 is added to the Labor Code, to read:4600.05. (a) All employers, as defined in Section 3300, shall provide immediately accessible advocacy services for employees employees, including first responders, injured in the course of employment by an act of domestic terrorism, as defined in Section 2331 of Title 18 of the United States Code, to assist injured employees in obtaining medical treatment and to assist providers of medical services in seeking authorization and payment of medical treatment. These advocacy services may be provided by the employer, the employers insurer, or the employers claims administrator.(b)This section shall apply only when the Governor has declared a state of emergency pursuant to subdivision (b) of Section 8558 of the Government Code in connection with the act of domestic terrorism.(b) Medical treatment, including psychological counseling, requested by a physician treating an employee pursuant to subdivision (a) shall be presumed to be consistent with the guidelines adopted by the administrative director pursuant to Section 5307.27. This presumption is disputable and may be controverted by other evidence, but unless so controverted, the independent medical reviewer and the appeals board are bound to find in accordance with it. The absence of documentation is not sufficient to rebut this presumption if the documentation is in the possession of, or available to, the employer, the employers insurer, or the employers claims administrator.(c) The determination to authorize or deny requested medical treatment shall be made in a timely fashion that is appropriate for the nature of the employees condition, not to exceed five working days from the receipt of the request for authorization. If the treatment is denied, an independent medical review determination shall be issued no more than 45 days from the receipt of the request for authorization.(d) The advocate provided by the employer pursuant to subdivision (a) shall assist the employee, the employees physician, and the employees representative, if any, to obtain authorization for the requested medical treatment, shall ensure the independent medical review process described in subdivision (c) is initiated in a timely manner, and shall provide the independent medical reviewer a narrative explaining why the treatment should be authorized, including citing relevant medical records.(e) If the treatment is denied, or if the employer, insurer, or advocate provided by the employer pursuant to subdivision (a) fails to meet the timeframes or any other requirements of this section, the appeals board shall determine whether the requested treatment and all subsequently requested treatment and all subsequently requested treatment is medically necessary. An expedited hearing shall be held and the determination shall be made and filed within 30 days after the declaration of readiness is filed.(c)Nothing in this section is(f) This section is not intended to alter the conditions for compensability of an injury, as defined in Section 3600.(g) The time limits in this section are mandatory. To the extent that the provisions of this section conflict with the provisions of Sections 4610 and 4610.5, the provisions in this section shall control.(d)(h) The administrative director shall adopt regulations to implement this section. section no later than July 1, 2018.(i) This section, and subparagraph (J) of paragraph (3) of subdivision (c) of Section 4656 shall apply retroactively to the employees and first responders injured in the terrorist attack in San Bernardino on December 2, 2015, and any other employees or first responders injured by an act of domestic terrorism that occurred before January 1, 2018.
SECTION 1. Section 4600.05 is added to the Labor Code, to read:
### SECTION 1.
4600.05. (a) All employers, as defined in Section 3300, shall provide immediately accessible advocacy services for employees employees, including first responders, injured in the course of employment by an act of domestic terrorism, as defined in Section 2331 of Title 18 of the United States Code, to assist injured employees in obtaining medical treatment and to assist providers of medical services in seeking authorization and payment of medical treatment. These advocacy services may be provided by the employer, the employers insurer, or the employers claims administrator.(b)This section shall apply only when the Governor has declared a state of emergency pursuant to subdivision (b) of Section 8558 of the Government Code in connection with the act of domestic terrorism.(b) Medical treatment, including psychological counseling, requested by a physician treating an employee pursuant to subdivision (a) shall be presumed to be consistent with the guidelines adopted by the administrative director pursuant to Section 5307.27. This presumption is disputable and may be controverted by other evidence, but unless so controverted, the independent medical reviewer and the appeals board are bound to find in accordance with it. The absence of documentation is not sufficient to rebut this presumption if the documentation is in the possession of, or available to, the employer, the employers insurer, or the employers claims administrator.(c) The determination to authorize or deny requested medical treatment shall be made in a timely fashion that is appropriate for the nature of the employees condition, not to exceed five working days from the receipt of the request for authorization. If the treatment is denied, an independent medical review determination shall be issued no more than 45 days from the receipt of the request for authorization.(d) The advocate provided by the employer pursuant to subdivision (a) shall assist the employee, the employees physician, and the employees representative, if any, to obtain authorization for the requested medical treatment, shall ensure the independent medical review process described in subdivision (c) is initiated in a timely manner, and shall provide the independent medical reviewer a narrative explaining why the treatment should be authorized, including citing relevant medical records.(e) If the treatment is denied, or if the employer, insurer, or advocate provided by the employer pursuant to subdivision (a) fails to meet the timeframes or any other requirements of this section, the appeals board shall determine whether the requested treatment and all subsequently requested treatment and all subsequently requested treatment is medically necessary. An expedited hearing shall be held and the determination shall be made and filed within 30 days after the declaration of readiness is filed.(c)Nothing in this section is(f) This section is not intended to alter the conditions for compensability of an injury, as defined in Section 3600.(g) The time limits in this section are mandatory. To the extent that the provisions of this section conflict with the provisions of Sections 4610 and 4610.5, the provisions in this section shall control.(d)(h) The administrative director shall adopt regulations to implement this section. section no later than July 1, 2018.(i) This section, and subparagraph (J) of paragraph (3) of subdivision (c) of Section 4656 shall apply retroactively to the employees and first responders injured in the terrorist attack in San Bernardino on December 2, 2015, and any other employees or first responders injured by an act of domestic terrorism that occurred before January 1, 2018.
4600.05. (a) All employers, as defined in Section 3300, shall provide immediately accessible advocacy services for employees employees, including first responders, injured in the course of employment by an act of domestic terrorism, as defined in Section 2331 of Title 18 of the United States Code, to assist injured employees in obtaining medical treatment and to assist providers of medical services in seeking authorization and payment of medical treatment. These advocacy services may be provided by the employer, the employers insurer, or the employers claims administrator.(b)This section shall apply only when the Governor has declared a state of emergency pursuant to subdivision (b) of Section 8558 of the Government Code in connection with the act of domestic terrorism.(b) Medical treatment, including psychological counseling, requested by a physician treating an employee pursuant to subdivision (a) shall be presumed to be consistent with the guidelines adopted by the administrative director pursuant to Section 5307.27. This presumption is disputable and may be controverted by other evidence, but unless so controverted, the independent medical reviewer and the appeals board are bound to find in accordance with it. The absence of documentation is not sufficient to rebut this presumption if the documentation is in the possession of, or available to, the employer, the employers insurer, or the employers claims administrator.(c) The determination to authorize or deny requested medical treatment shall be made in a timely fashion that is appropriate for the nature of the employees condition, not to exceed five working days from the receipt of the request for authorization. If the treatment is denied, an independent medical review determination shall be issued no more than 45 days from the receipt of the request for authorization.(d) The advocate provided by the employer pursuant to subdivision (a) shall assist the employee, the employees physician, and the employees representative, if any, to obtain authorization for the requested medical treatment, shall ensure the independent medical review process described in subdivision (c) is initiated in a timely manner, and shall provide the independent medical reviewer a narrative explaining why the treatment should be authorized, including citing relevant medical records.(e) If the treatment is denied, or if the employer, insurer, or advocate provided by the employer pursuant to subdivision (a) fails to meet the timeframes or any other requirements of this section, the appeals board shall determine whether the requested treatment and all subsequently requested treatment and all subsequently requested treatment is medically necessary. An expedited hearing shall be held and the determination shall be made and filed within 30 days after the declaration of readiness is filed.(c)Nothing in this section is(f) This section is not intended to alter the conditions for compensability of an injury, as defined in Section 3600.(g) The time limits in this section are mandatory. To the extent that the provisions of this section conflict with the provisions of Sections 4610 and 4610.5, the provisions in this section shall control.(d)(h) The administrative director shall adopt regulations to implement this section. section no later than July 1, 2018.(i) This section, and subparagraph (J) of paragraph (3) of subdivision (c) of Section 4656 shall apply retroactively to the employees and first responders injured in the terrorist attack in San Bernardino on December 2, 2015, and any other employees or first responders injured by an act of domestic terrorism that occurred before January 1, 2018.
4600.05. (a) All employers, as defined in Section 3300, shall provide immediately accessible advocacy services for employees employees, including first responders, injured in the course of employment by an act of domestic terrorism, as defined in Section 2331 of Title 18 of the United States Code, to assist injured employees in obtaining medical treatment and to assist providers of medical services in seeking authorization and payment of medical treatment. These advocacy services may be provided by the employer, the employers insurer, or the employers claims administrator.(b)This section shall apply only when the Governor has declared a state of emergency pursuant to subdivision (b) of Section 8558 of the Government Code in connection with the act of domestic terrorism.(b) Medical treatment, including psychological counseling, requested by a physician treating an employee pursuant to subdivision (a) shall be presumed to be consistent with the guidelines adopted by the administrative director pursuant to Section 5307.27. This presumption is disputable and may be controverted by other evidence, but unless so controverted, the independent medical reviewer and the appeals board are bound to find in accordance with it. The absence of documentation is not sufficient to rebut this presumption if the documentation is in the possession of, or available to, the employer, the employers insurer, or the employers claims administrator.(c) The determination to authorize or deny requested medical treatment shall be made in a timely fashion that is appropriate for the nature of the employees condition, not to exceed five working days from the receipt of the request for authorization. If the treatment is denied, an independent medical review determination shall be issued no more than 45 days from the receipt of the request for authorization.(d) The advocate provided by the employer pursuant to subdivision (a) shall assist the employee, the employees physician, and the employees representative, if any, to obtain authorization for the requested medical treatment, shall ensure the independent medical review process described in subdivision (c) is initiated in a timely manner, and shall provide the independent medical reviewer a narrative explaining why the treatment should be authorized, including citing relevant medical records.(e) If the treatment is denied, or if the employer, insurer, or advocate provided by the employer pursuant to subdivision (a) fails to meet the timeframes or any other requirements of this section, the appeals board shall determine whether the requested treatment and all subsequently requested treatment and all subsequently requested treatment is medically necessary. An expedited hearing shall be held and the determination shall be made and filed within 30 days after the declaration of readiness is filed.(c)Nothing in this section is(f) This section is not intended to alter the conditions for compensability of an injury, as defined in Section 3600.(g) The time limits in this section are mandatory. To the extent that the provisions of this section conflict with the provisions of Sections 4610 and 4610.5, the provisions in this section shall control.(d)(h) The administrative director shall adopt regulations to implement this section. section no later than July 1, 2018.(i) This section, and subparagraph (J) of paragraph (3) of subdivision (c) of Section 4656 shall apply retroactively to the employees and first responders injured in the terrorist attack in San Bernardino on December 2, 2015, and any other employees or first responders injured by an act of domestic terrorism that occurred before January 1, 2018.
4600.05. (a) All employers, as defined in Section 3300, shall provide immediately accessible advocacy services for employees employees, including first responders, injured in the course of employment by an act of domestic terrorism, as defined in Section 2331 of Title 18 of the United States Code, to assist injured employees in obtaining medical treatment and to assist providers of medical services in seeking authorization and payment of medical treatment. These advocacy services may be provided by the employer, the employers insurer, or the employers claims administrator.
(b)This section shall apply only when the Governor has declared a state of emergency pursuant to subdivision (b) of Section 8558 of the Government Code in connection with the act of domestic terrorism.
(b) Medical treatment, including psychological counseling, requested by a physician treating an employee pursuant to subdivision (a) shall be presumed to be consistent with the guidelines adopted by the administrative director pursuant to Section 5307.27. This presumption is disputable and may be controverted by other evidence, but unless so controverted, the independent medical reviewer and the appeals board are bound to find in accordance with it. The absence of documentation is not sufficient to rebut this presumption if the documentation is in the possession of, or available to, the employer, the employers insurer, or the employers claims administrator.
(c) The determination to authorize or deny requested medical treatment shall be made in a timely fashion that is appropriate for the nature of the employees condition, not to exceed five working days from the receipt of the request for authorization. If the treatment is denied, an independent medical review determination shall be issued no more than 45 days from the receipt of the request for authorization.
(d) The advocate provided by the employer pursuant to subdivision (a) shall assist the employee, the employees physician, and the employees representative, if any, to obtain authorization for the requested medical treatment, shall ensure the independent medical review process described in subdivision (c) is initiated in a timely manner, and shall provide the independent medical reviewer a narrative explaining why the treatment should be authorized, including citing relevant medical records.
(e) If the treatment is denied, or if the employer, insurer, or advocate provided by the employer pursuant to subdivision (a) fails to meet the timeframes or any other requirements of this section, the appeals board shall determine whether the requested treatment and all subsequently requested treatment and all subsequently requested treatment is medically necessary. An expedited hearing shall be held and the determination shall be made and filed within 30 days after the declaration of readiness is filed.
(c)Nothing in this section is
(f) This section is not intended to alter the conditions for compensability of an injury, as defined in Section 3600.
(g) The time limits in this section are mandatory. To the extent that the provisions of this section conflict with the provisions of Sections 4610 and 4610.5, the provisions in this section shall control.
(d)
(h) The administrative director shall adopt regulations to implement this section. section no later than July 1, 2018.
(i) This section, and subparagraph (J) of paragraph (3) of subdivision (c) of Section 4656 shall apply retroactively to the employees and first responders injured in the terrorist attack in San Bernardino on December 2, 2015, and any other employees or first responders injured by an act of domestic terrorism that occurred before January 1, 2018.
SEC. 2. Section 4656 of the Labor Code is amended to read:4656. (a) Aggregate disability payments for a single injury occurring prior to January 1, 1979, causing temporary disability shall not extend for more than 240 compensable weeks within a period of five years from the date of the injury.(b) Aggregate disability payments for a single injury occurring on or after January 1, 1979, and prior to April 19, 2004, causing temporary partial disability shall not extend for more than 240 compensable weeks within a period of five years from the date of the injury.(c) (1) Aggregate disability payments for a single injury occurring on or after April 19, 2004, causing temporary disability shall not extend for more than 104 compensable weeks within a period of two years from the date of commencement of temporary disability payment.(2) Aggregate disability payments for a single injury occurring on or after January 1, 2008, causing temporary disability shall not extend for more than 104 compensable weeks within a period of five years from the date of injury.(3) Notwithstanding paragraphs (1) and (2), for an employee who suffers from the following injuries or conditions, aggregate disability payments for a single injury occurring on or after April 19, 2004, causing temporary disability shall not extend for more than 240 compensable weeks within a period of five years from the date of the injury:(A) Acute and chronic hepatitis B.(B) Acute and chronic hepatitis C.(C) Amputations.(D) Severe burns.(E) Human immunodeficiency virus (HIV).(F) High-velocity eye injuries.(G) Chemical burns to the eyes.(H) Pulmonary fibrosis.(I) Chronic lung disease.(J) Injuries arising from an act of domestic terrorism, as described in Section 4600.05.
SEC. 2. Section 4656 of the Labor Code is amended to read:
### SEC. 2.
4656. (a) Aggregate disability payments for a single injury occurring prior to January 1, 1979, causing temporary disability shall not extend for more than 240 compensable weeks within a period of five years from the date of the injury.(b) Aggregate disability payments for a single injury occurring on or after January 1, 1979, and prior to April 19, 2004, causing temporary partial disability shall not extend for more than 240 compensable weeks within a period of five years from the date of the injury.(c) (1) Aggregate disability payments for a single injury occurring on or after April 19, 2004, causing temporary disability shall not extend for more than 104 compensable weeks within a period of two years from the date of commencement of temporary disability payment.(2) Aggregate disability payments for a single injury occurring on or after January 1, 2008, causing temporary disability shall not extend for more than 104 compensable weeks within a period of five years from the date of injury.(3) Notwithstanding paragraphs (1) and (2), for an employee who suffers from the following injuries or conditions, aggregate disability payments for a single injury occurring on or after April 19, 2004, causing temporary disability shall not extend for more than 240 compensable weeks within a period of five years from the date of the injury:(A) Acute and chronic hepatitis B.(B) Acute and chronic hepatitis C.(C) Amputations.(D) Severe burns.(E) Human immunodeficiency virus (HIV).(F) High-velocity eye injuries.(G) Chemical burns to the eyes.(H) Pulmonary fibrosis.(I) Chronic lung disease.(J) Injuries arising from an act of domestic terrorism, as described in Section 4600.05.
4656. (a) Aggregate disability payments for a single injury occurring prior to January 1, 1979, causing temporary disability shall not extend for more than 240 compensable weeks within a period of five years from the date of the injury.(b) Aggregate disability payments for a single injury occurring on or after January 1, 1979, and prior to April 19, 2004, causing temporary partial disability shall not extend for more than 240 compensable weeks within a period of five years from the date of the injury.(c) (1) Aggregate disability payments for a single injury occurring on or after April 19, 2004, causing temporary disability shall not extend for more than 104 compensable weeks within a period of two years from the date of commencement of temporary disability payment.(2) Aggregate disability payments for a single injury occurring on or after January 1, 2008, causing temporary disability shall not extend for more than 104 compensable weeks within a period of five years from the date of injury.(3) Notwithstanding paragraphs (1) and (2), for an employee who suffers from the following injuries or conditions, aggregate disability payments for a single injury occurring on or after April 19, 2004, causing temporary disability shall not extend for more than 240 compensable weeks within a period of five years from the date of the injury:(A) Acute and chronic hepatitis B.(B) Acute and chronic hepatitis C.(C) Amputations.(D) Severe burns.(E) Human immunodeficiency virus (HIV).(F) High-velocity eye injuries.(G) Chemical burns to the eyes.(H) Pulmonary fibrosis.(I) Chronic lung disease.(J) Injuries arising from an act of domestic terrorism, as described in Section 4600.05.
4656. (a) Aggregate disability payments for a single injury occurring prior to January 1, 1979, causing temporary disability shall not extend for more than 240 compensable weeks within a period of five years from the date of the injury.(b) Aggregate disability payments for a single injury occurring on or after January 1, 1979, and prior to April 19, 2004, causing temporary partial disability shall not extend for more than 240 compensable weeks within a period of five years from the date of the injury.(c) (1) Aggregate disability payments for a single injury occurring on or after April 19, 2004, causing temporary disability shall not extend for more than 104 compensable weeks within a period of two years from the date of commencement of temporary disability payment.(2) Aggregate disability payments for a single injury occurring on or after January 1, 2008, causing temporary disability shall not extend for more than 104 compensable weeks within a period of five years from the date of injury.(3) Notwithstanding paragraphs (1) and (2), for an employee who suffers from the following injuries or conditions, aggregate disability payments for a single injury occurring on or after April 19, 2004, causing temporary disability shall not extend for more than 240 compensable weeks within a period of five years from the date of the injury:(A) Acute and chronic hepatitis B.(B) Acute and chronic hepatitis C.(C) Amputations.(D) Severe burns.(E) Human immunodeficiency virus (HIV).(F) High-velocity eye injuries.(G) Chemical burns to the eyes.(H) Pulmonary fibrosis.(I) Chronic lung disease.(J) Injuries arising from an act of domestic terrorism, as described in Section 4600.05.
4656. (a) Aggregate disability payments for a single injury occurring prior to January 1, 1979, causing temporary disability shall not extend for more than 240 compensable weeks within a period of five years from the date of the injury.
(b) Aggregate disability payments for a single injury occurring on or after January 1, 1979, and prior to April 19, 2004, causing temporary partial disability shall not extend for more than 240 compensable weeks within a period of five years from the date of the injury.
(c) (1) Aggregate disability payments for a single injury occurring on or after April 19, 2004, causing temporary disability shall not extend for more than 104 compensable weeks within a period of two years from the date of commencement of temporary disability payment.
(2) Aggregate disability payments for a single injury occurring on or after January 1, 2008, causing temporary disability shall not extend for more than 104 compensable weeks within a period of five years from the date of injury.
(3) Notwithstanding paragraphs (1) and (2), for an employee who suffers from the following injuries or conditions, aggregate disability payments for a single injury occurring on or after April 19, 2004, causing temporary disability shall not extend for more than 240 compensable weeks within a period of five years from the date of the injury:
(A) Acute and chronic hepatitis B.
(B) Acute and chronic hepatitis C.
(C) Amputations.
(D) Severe burns.
(E) Human immunodeficiency virus (HIV).
(F) High-velocity eye injuries.
(G) Chemical burns to the eyes.
(H) Pulmonary fibrosis.
(I) Chronic lung disease.
(J) Injuries arising from an act of domestic terrorism, as described in Section 4600.05.